Observation of the Clinical efficacy of Sevoflurane Combined with Airway Pressure Release Ventilation in the Treatment of Severe ARDS Caused by Trauma
Objective To explore the efficacy of sevoflurane and airway pressure release ventilation in the treatment of severe acute respiratory distress syndrome(ARDS)caused by trauma.Methods A total of 80 patients with severe ARDS were selected from Nanyang Central Hospital between January 2020 to December 2022.According to random number table,patients were divided into control group(n=40)and observation group(n=40).The control group received airway pressure release ventilation treatment,while the observation group received additional treatment with sivelestat sodium.The blood gas,inflammatory factors,hemodynamic indicators,and prognosis were compared between the two groups.Results Before treatment,there were no statistically significant difference in partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),and PaO/fraction of inspired oxygen(FiO2)values between the two groups(P＞0.05).After 24 hours and 72 hours of treatment,the PaCO2 values in both groups were lower than before treatment,while the PaO2 and PaO2/FiO2 values were higher than before treatment.The PaCO2 value in the observation group was lower than that in the control group,and the PaO2 and PaO2/FiO2 values in the observation group were higher than those in the control group,indicating statistically significant differences(P＜0.05).Before treatment,there were no statistically significant differences in interleukin-6(IL-6),procalcitonin(PCT),and C-reactive protein(CRP)values between the two groups(P＞0.05).After treatment,the IL-6,PCT,and CRP values in both groups were lower than before treatment,and the IL-6,PCT,and CRP values in the observation group were lower than those in the control group,indicating statistically significant differences(P＜0.05).Before treatment,there were no statistically significant differences in central venous pressure(CVP),heart rate(HR),and mean arterial pressure(MAP)values between the two groups(P＞0.05).After 24 hours and 72 hours of treatment,the CVP,HR,and MAP values in the control group were lower than before treatment,while the HR value in the observation group was lower than before treatment,and the MAP value at 24 hours after treatment was lower than before treatment,indicating statistically significant differences(P＜0.05).After 24 hours and 72 hours of treatment,the CVP,HR,and MAP values in the observation group were higher than those in the control group,indicating statistically significant differences(P＜0.05).Before treatment,there were no statistically significant differences in acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores between the two groups(P＞0.05).After treatment,the APACHE II scores in both groups were lower than before treatment,and the observation group had a lower score than the control group,indicating statistically significant differences(P＜0.05).Conclusion Sivelestat sodium and airway pressure release ventilation can reduce the inflammatory factors,improve the blood gas analysis indicators,treatment effects and prognosis for trauma-induced severe acute respiratory distress syndrome patients.
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